European countries' failure to regulate baby milk marketing results in downgrading in global ranking presented at World Health Assembly IBFAN press release 21 May 2009 Nearly all European countries were moved down into a lower category on a chart summarizing government efforts to protect breastfeeding. The International Baby Food Action Network Network (IBFAN) decided on the move in its 2009 State of the Code by Country chart, launched today at the World Health Assembly in Geneva. In 2006 a new recast Directive adopted by the European Union (EU) failed to meet the minimum standard set by the International Code of Marketing of Breastmilk Substitutes, the landmark recommendation endorsed in 1981 by all except one of the WHO Member States. Subsequent resolutions, adopted by all at several World Health Assemblies, clarify and extend the provisions of the Code and should rightly have been incorporated into the new Directive.  Many of these were ignored making it difficult, but not impossible, for countries to strengthen their laws in line with the World Health Assembly recommendations. According to the State of the Code chart, only two European countries, Luxemburg and Norway,  adopted additional measures, necessary to safeguard breastfeeding against commercial competition. These two remain in category 2 while all other European countries as well as China and Papua New Guinea were downgraded to category 3 (see below for description of categories). The chart was researched by the International Code Documentation Centre (ICDC), a specialized technical office of IBFAN. ICDC has been keeping track of steps by all 196 Member States of WHO. State of the Code charts have been published every 3 years since 1986. This year, ICDC’s Director, Annelies Allain, says: “We congratulate Norway and Luxembourg for being more ‘baby friendly’ than the other countries in Europe. The others deserve to be downgraded, the basic EU Directive does not meet the minimum standards of the Code and its subsequent resolutions; it is not sensitive to changing marketing practices by the large babyfood companies who only seek to expand their sales and have found a dozen ways around existing legislation.” The market is now controlled by two giants: Nestlé and Danone who are in a neck and neck race for world market share. Nestlé bought up Gerber, an American company known for its jarred foods. Danone, mostly known for its cookies and yogourts, in one fell swoop, acquired Dutch NUMICO, itself a huge conglomerate of 6 large Dutch, German, British, Danish and Indonesian companies. When IBFAN started 'grading' countries, there were few who had adopted legislation and those who had were applauded. As years went by and more government officials were trained by ICDC, more and better laws were adopted. Now about 70% of all countries have adopted some measure or other to implement the Code.  Not all of these are comprehensive or have adequate sanctions and it was time to fine-tune IBFAN's grading system. Some of the older laws were also downgraded as they no longer meet the mark. The present State of the Code chart truly reflects the global extent of legal measures to protect breastfeeding.                                                                                                           Contact at WHA: Annelies Allain 076-216 9164 Or: IBFAN-GIFA 022-798 9164 Summary of the 2009 State of the Code by Country In 2008, IBFAN-ICDC started a new survey on the steps taken by 196 countries to implement the International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly (WHA) resolutions (collectively referred to as ‘the Code’). Based on input from governments and IBFAN groups, it was decided to revise the criteria for grading countries using the ‘scope’ of the law as the main yardstick. Any law that does not cover all breastmilk substitutes, such as follow-on milks,  will not, as a matter of principle, qualify for category 1 or 2.  As a result a number of countries have been downgraded. 30 countries in category 1 implemented most of the Code’s provisions as law. The Gambia, Maldives, Palau, and Venezuela are new entrants to this category.  A few countries in category 1 have reviewed their existing laws to include subsequent WHA resolutions, namely Lebanon and the Philippines. 33 countries in category 2 have implemented many but not all provisions of the Code as law, decree or other legally enforceable measures. New entrants to this category are Bolivia, Congo D.R., Kyrgyzstan, Mali, Syria and Tajikistan. Significantly, Argentina, Burkina Faso, Saudi Arabia and Uruguay have been downgraded from category 1 to category 2 as their laws no longer make the mark under the re-classification. Only two countries in Europe: Norway and Luxembourg remain in category 2. The re-classification made it possible to fine-tune the grading.  Category 3 is new, the 42 countries in this category have chosen to maintain a narrow ‘scope’ and have not taken into account subsequent World Health Assembly Resolutions.  China, Papua New Guinea and most EU countries have been downgraded from 2 as they do not meet the minimum envisaged by WHA when the Code was adopted. 17 countries in category 4have implemented the entire Code as a voluntary measure.  Although such measures are not legally enforceable, they can be effective if properly monitored.  Palestine has been upgraded to this category, while Honduras slipped here from its previous category 1 position when its law got suspended. Five countries namely Algeria, Armenia, Canada, Macedonia and United Arab Emirates are in category 5, newly reclassified to cater for the few countries which incorporated parts of the Code into other laws, in particular those pertaining to labelling, quality and consumer protection. Category 6, another revised classification lists 23 countries which have some voluntary provisions. Although the approach taken in category 6 is voluntary and similar to that of category 4, countries in category 6 enjoy less protection from their national measures, either due to dominant industry influence or the lack of independent monitoring mechanisms. 22 countries in category 7 have draft laws.  Some countries have remained in this category for many years and appear to have become complacent in relation to Code implementation. Category 8 lists countries where the Code is being studied, while category 9 is a combination of countries where there is either no information or no action.